6B Goals

The goal of the Obstetrics/Gynecology clerkship is to provide the medical student with experience in Obstetrics/Gynecology problems and instruction on doing an adequate pelvic examination. The student should become familiar with common problems in this rotation; however, each student should try to maximize their opportunities for seeing and learning about the broad spectrum of Obstetrics/Gynecology issues during this clerkship.

The minimum experience of each student will be:

1) Participate in 10 deliveries (performing 3 deliveries)

2) Assist with 5 hysterectomies/major surgeries

3) Assist with 5 cesarean sections

4) Perform 10 pelvic exams (do more)

5) Participate in 2 gynecologic laparoscopies

6) Observe an obstetrical ultrasound

For most students, the Obstetrics/Gynecology Clerkship will be kept at Kapiolani Medical Center for Women & Children. The Clerkship is divided into three rotations: Obstetrics (Labor & Delivery), Gynecology (Surgery) and Ambulatory (Women’s Outpatient Clinic) rotations. This schedule provides the maximum possible exposure for the student. A rotation schedule is provided during the orientation. Weekly Obstetrics and Gynecology Grand Rounds, resident conferences and student lectures are mandatory.

On the Obstetrics, Gynecology and Ambulatory rotations, the student is responsible for reporting to the Chief Resident. The student will be taking night and weekend/holiday call. The medical student call schedule will be distributed at orientation.

Because of the large number of students during each block rotation, a few students may do their Obstetrics/Gynecology clerkship at Queen’s Medical Center. During this clerkship, the student also gains experience in Obstetrics (Labor & Delivery), Gynecology (Surgery) and Ambulatory (Queen Emma Clinic) medicine. Again, detailed information on this clerkship, the call schedule and other information are distributed during orientation.

If the student was involved with a patient’s surgery, delivery or admission to the floor, they are expected to follow this patient until discharge from the hospital. The student will follow patients throughout the duration of the rotation. The student should NEVER do a pelvic examination without a Resident or an Attending Physician present.

CLINICAL ASSIGNMENT

Introduction to Ob/Gyn – Orientation

The student will have a day of orientation to the Ob/Gyn clerkship. During this time, students will be given instructions in technical aspects such as pelvic examinations and labor & delivery guidelines.

Obstetrics

The service is run by the Obstetrics Chief Resident. Report to the Chief on the first day of the rotation. Sign-in at 6:45am in conference room #815 with the OB team and sign-out your patients to the student on call at 5:00pm. Student(s) on call will sign-out with the team at 5:30pm in L&D. DO NOT leave the floor without notifying the Chief or Senior Resident. The student will be assigned to the Labor & Delivery suite and postpartum wards. You will perform the initial evaluation of laboring patients, participate in the management of labor and delivery, and follow the patient while in the hospital with the Attending and Resident staff.

Gynecology – Surgery

The student is assigned to the Gynecologic service and will be responsible for the evaluation of patients before, during and after surgery, including both routine and emergent surgeries. You will also participate in surgery and make post-operative evaluations on a daily basis. You should page your Gynecology Chief Resident prior to starting the rotation so that you can be assigned to cases. Sign-in and sign-out times may vary. Your Gyn Chief should know where you are at all times. PLEASE review outpatient surgical patient charts BEFORE scrubbing in on cases; know what procedures are being done and why!

Ambulatory Care

Outpatient experience will be at the Kapiolani and Queen Emma Clinics. Clinic hours vary – so check the schedule. The students will see patients with routine as well as minor/major complaints. The basic principles of Ambulatory Obstetrics and Gynecology should be learned. Students will also observe/participate in Ambulatory surgical procedures. NOTE: There is a Chief Resident assigned to each rotation. The students are to report to that Chief and should keep her/him apprised of your whereabouts. If you are out sick, you are REQUIRED to contact your Chief Resident as well as the Student Coordinator. If you are sick and cannot work for more than 1 (one) day, you must submit a doctor’s note to the Student Coordinator upon your return.

PBL Curriculum

The PBL sessions will be held 2 (two) times a week during the 7 (seven) week rotation. The times and sites of the sessions will be scheduled with the Faculty tutor. There are 7 (seven) PBL cases. During the first week, Case No. 1 will be discussed during a one-hour session; this problem will then be completed at the second session during the first hour. The second hour of the session will be used to develop the next problem (Case No. 2). PBL sessions are REQUIRED and cannot be missed.

EVALUATION

Purpose

In this clerkship, evaluation is used to reveal your strengths and limitations, determining whether you have mastered course objectives and to assign grades. Your grade in Ob/Gyn is based on the written examination, PBL evaluations and clinical performance.

FINAL EXAM

A written final examination will be given on the last Friday of the block rotation.

PBL Evaluation

Your PBL tutors will evaluate you.

Faculty & Resident Evaluations

This is an important portion of your grade and is based on your clinical performance on the wards.